Healthcare Provider Details

I. General information

NPI: 1568286052
Provider Name (Legal Business Name): SANTO NINO HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14860 ROSCOE BLVD STE 200
PANORAMA CITY CA
91402-4683
US

IV. Provider business mailing address

14427 CHASE ST STE 100
PANORAMA CITY CA
91402-3020
US

V. Phone/Fax

Practice location:
  • Phone: 818-830-7751
  • Fax:
Mailing address:
  • Phone: 818-830-7751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIETTE N AROUTIOUNIAN
Title or Position: VICE PRESIDENT, CLINIC OPERATIONS
Credential:
Phone: 323-236-4709